2124NOTE, 1
With groper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
' PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
4/8/94 Subdivision Improvement Permit — Class II I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Move Equipment Sketch (attach construction plans if appropriate)
62.45 Scraper
DESCRIPTION OF CP4'j,RlLjCTd+ I
o ,
Haul Route: East City Limits to
Washington St. Notth on Washington
DIMENSION OF INSTALLATION OR REMOVAL
to ave. 48 to Rancho La Quinta.
Haul Date: 4/8/94
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the resul of this wo vkr
rL,
Signature of Applicant or Agent
Piconi Trucking 39723 Old Carriage Rd, Murrieta, CA 92362 (714)677-8196
Name of Applicant (please print) Business Address Telephone No.
On File
Name of Contractor and Job Foreman Business Address Telephone No.
On File on File
Contractor's License No. City Business License No.
On File
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
Public improvements: 3% of estimated construction costs,
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit -Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
10.00
$ 10.00
Date
2124
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DAT SS D
By
Administrative Authority
Recorded by . 11 TELEPHONE: (619) 564-2246
--------------------------=---------------------------------------------
e N0T0�
With proper validatlon ,AS
thlo fern —..tl .us.. an f'1 .Or. LAjj{:�UINTA
o.ahment oarmlt
4RPLEF4Ff N ' q"I vel WIT
' "' � � Pl')®L10 WORKS OQN>9TRUCTION (QNG ROAOKM6NT)
For the construction of Public or Private curb., drlyowoy., fxy.man[e. eldawelke, Perko— lot., r'•mlln.
and oah.r Ilk. public work. Im Prev.m.nt. I)t oeltrtaetlon Livith MIr117 jr IMPROVIMgNTB Ind APPROVED SUBDIVISIONS ,
aie/o4 flH¢NI"Llogimprgym•o:Parn.lt-algr{u
OA76( Minor Ir7!Pi4yITIRt Pirmlt Clcai IV
LOCATION OP CONE rRUCTION
.«.._.. _sees.. .. ... _.........._.. sees _.. .. ... .. sees ... .. _. .. •
(Owea ad.—.. or O...rIPelPn a lOw,tleryl .. •... ••.. .. . _.. see s. .. _.. ..
PURPOSE OF CONSTRUCTION —21. Sketch (eeLch gon.tru gtlen plan. If appropriate)
.. sees_. _sees. ... .. .. _._... .. ...
' OESORIPTION
OF -or—RU
4T �S1N ' •.• era ar^sees. _. _ ,sees. _... ._...
_.. .. _._. sees ..._.. .. .. Haul Roueal Bas! CSlY Limits to
DIMENSION OF iNST.ALLATi C'N OR ItEMOV ALWaa1[SagC oa SC. Nor tTt' Oa Waelhing Cea
to ova_ 4B to Haacuo La qulaColo.
.
. .. .............. .. .. ........
SIZE OF EXCAVATION, IF NHEDEG "'"" "' Hattl Dae.. 4/8/04
sees.. .. .. _ .. ..
APPROXIMATH TIMH WMBN WORK WIt: L'SgOiIU '
APPROXIMATE TIMH OF COMPLETION '
EOTIMATSO CONSTRUCTION COST•"
Ilnolutl lnp r v.l of all ob.truatlon, matarlati,' ind'd4tiili, biok1fllln0. owm-
pltRlon end placing
Permanent r..urflufrtp ind/or, raP1"'np I—rovamint.) .
in eon.id.reti— of the Orontln9 Of thl. P.rm,t, the Opp4l—.% he Mby ealee. tyr
In.aTnlaY..dMend snd w fhe DIN. I...... •rlr
rl..o n)., o111e.r., r .entaev,— entl . plovee.,•nwl
erla.. teem end .e.lnvo{ .
^. n.ltl... Il.kllitle. OI M.ul<In0 tr9ry .lilri.. 'ai •cure e.elen end 'wr-to .
of enY olden<, 1 r d.ri.�a. tn- mor. o r P-4,
rrinp l.. •. Proalrr.eee .uli ;if enY work ulldor[ek.n neer tai P rmlt prem.. PLA'..... to tfi 1. .PPllwtl.n.
Ne•IN Ie Aominl.er.tly. AuthorlN et I..N t1Ysn<YAeur (i41 hour. In .dv.n.e of eh. carne when work will
Oom p.V w1V. . ppll..bl. OIN Ordl....... h, m1 end gendltloN Pt •eh. P.rml{ end ell .ppflc.bl. wIr and repule<lon. of she Cm, of
V oulnv end lee P.V for .nV eddhlon.l tepfe �r.fihe, n .. t11e iitwl[ vaOr
i.irei V �r
o SI9h!![u ra o1 Appllwrlc or A9.
Yiooai Truc1ciaa S9729 Old. Carriage -SA. Matrriaea. OA 92962 (714)677-13196
Name of Contractor e J or.rnan Telfbhon. No.
O,7 7110 Oa Yiie
Cont—tor'. Lloen.. No. City Hv.lnoge Liwn.o No. ",
Cat H'iia
Applicant'. In.uranw CPTPeny "'' Policy Number
FRED, Bubd(vl.id rf Improvement Permit — Ols.. I11
1
Publle'linprovomaitt.f 396Of aaklritetad tfon.truatlon cost.
Prlvate.im Prov.mente: 3% of eptl r;<ited t2on.<rlfaL,4Pn ePsie
Minor Improvemint Permit — Cl.m IV. See attoohep .oh. Jui. 212&
Impaction Po. Q ,., _., PERMIT VA LIOATtON
Permit Pea .�A-nC, ., PERMIT NO. u
Penelej.
Cath O.Po.lt-Surety, Bond "_ """ '" OAT■ APPROVED
IfOATS
raeulrad t.J .
... sees sees sees..___. ._ EXPIRATION
TOTALf B
R—Ipt No.
.• ... .
Received by 6aSol_. ._.._. ..._ .y ... Admin retrativa Authorlty
cr
R.00rtled by ..,,., .,�_.—._. .,_•-.,-. TOLBP.M ON Bx (9i 9) 004.1740
TRANSMISSION REPORT
THIS DOCUMENT (REDUCED SAMPLE ABOVE)
WAS SENT
** COUNT
# 1
*** SEND ***
NO
REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
1
6193451778
. 4— 8-94 7:32AM
0'59"
1
TOTAL 0:00'59" 1
XEROX TELECOPIER 7020
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APR- S-494 F R I
G: -Ss N U E V O ENGINEERING
P . 0 1
NUEVO ENGINEERING, INC.
79-811 COUNTRY CLU13 (DRIVE • BERMUDA DUNES, CA 92201 a 5191345.1778
GENERAL ShIGINEERING CONTRACTOR • LICENSE NO. 438834
FAX (619) 345-6704
FAX TRANSMITTAL SHEET
PLEASE DELIVER THE FOLLOWING PAGES TO:
NAME S � P --
FAX NUMBER: '1 ---1 t D_ l
LOCATION:
FROM: 1 .
NUMBER OF PAT INCLUDING 'TRANSMITTAL
SHEET
DATE 4 TIME: �= aAv .,
IF YOU DO NOT RECEIVE ALL THE PAGES9 PLEASE
CONTACT THIS OFFICE AS SOON AS, POSSIBLE AT
THE ABOVE PHONE NUMBER.
-:. {
c
� +
9 4 F R I G 5 7 E N G.I N E E R I N G
NOTE:
With proper validation
Phis form "^ttstiuftrs +t+t
ialGlQdct+ttlL`ltl liClntlt
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION {ENCROACHMENT)
P . 0 2
For the MWIM-tinu of public or titivate curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE;1�.
LOCATION OF CONSTRUCTION - - - - ----_
Subdivision Improvement Permit T Class III — -
Minor Improvement Permit Class iV
(Street address or Description of Locotion)
PURPOSE OF CONSNIUCTION 1409 EQUIPMT Sketch (attach construction plans If appropriate)
DESCR(PITION OF CONS TRUCTION
DIMENSION OF INS -I -At LATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE T1MF Wi IEN WORK WILL BEGIN
®AUL ROUTE:
A
---
APPROXiMATE'TIME OF COMPLETION
NA L
ESTIMATED CONSTRUCTION COST $� `
(Including removal of all obstruction, materials, and debris, backfilling, com—
paction and placing hnrinane+it resurfacing and/or replacing improvements)
In consideration of Ih(r gtantiny of this permit, the applicant hereby agrees to;
Indv.mulfy, r (,11,1 1 a+MJ :r+vn Illr City, Its nulhorlred ngrnts, officers, rr;presrmtatives and on lovecs, harmlass from and against any and all
penallles, unl,ilities nr hiss resulting from claims or court action and arising out of any accident, loss or damage to persons or property
happening or orrrn'ong as a ntoximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Ad-Inisttn+ive. Authorlty at least twenty-four (24) hours In advance of the time when work will be started,
Comply witli all +rrWicatk. City Ordinnnces, the Irsms and conditions of the permit and all applicable rules and regulations of the City of
La Uulnia Intl to hay for any addition0l replacement necessary or. the result of this wolp 00
PICONI TRUCKING
Name of Applicant (please print)
re of Applicant orjA*nt
Business Address Telephone No.
NUEVO ENGINFFRiNG, INC 79-811 COUNTRY CLUB Dir., BEWDA DUDES, CA 34517ZA_
Nafne of Colitractor anti ,lob Foreman Business Address Telephone No,
ON PILE
Contractor's License No.
ON FILE
City Business License No.
ON FILE .-- .�_.. ON FILE
Applicant's insurance Company policy Number
FEES: Subdivision Improvement Permit —Class III
Public briprnvernents; 3% of estimated construction costs
Private iniprovements: 3% of estimated construction costs
Minor ImProveffient Permit — Class IV: See attached schedule
Inspection Fay $
Permit fee,
Penalty
Caih Deposit•Suoety 13nn(1
it required �.
TOTAL,
IZncOlrt Nn. __--
Received by _ Date
Recorded by ----
Extended Page 2.1
PERMIT VALIDATION
PERMIT NO..�.�,
DATE APPROVED -
EXPIRATION DATE,
DATE ISSUED _ _w
Administrative Authority
TELEPHONE: 1619) 664.2246